Correlates of Daytime Sleepiness in Patients With Posttraumatic Stress Disorder and Sleep Disturbance

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Objective: To assess the correlates of daytime sleepiness in patients with a lifetime diagnosis of posttraumatic stress disorder (PTSD) and ongoing sleep disturbance not due to sleep apnea or other diagnosed sleep disorders.

Method: The sample consisted of 26 veterans receiving mental health care at the Minneapolis VA Medical Center, Minneapolis, Minnesota. The Epworth Sleepiness Scale was the primary outcome measure. Other sleep-related instruments consisted of the Pittsburgh Sleep Quality Scale, a daily sleep log, and daily sleep actigraphy. In addition, data included 3 symptom ratings (Posttraumatic Stress Disorder Checklist, Clinician Administered PTSD Scale [CAPS], and Beck Depression Inventory). Data were collected from 2003 to 2005. Current and lifetime PTSD diagnoses were based on DSM-IV criteria and were obtained by experienced psychiatrists using the CAPS interview.

Results: Univariate analyses showed that daytime sleepiness on the Epworth Sleepiness Scale was associated with daytime dysfunction on the Pittsburgh Sleep Quality Index (P<.001), less use of sleeping medication (P=.02), and more self-rated posttraumatic symptoms (P=.05). Within posttraumatic symptom categories, hypervigilance symptoms were more correlated with daytime sleepiness (P=.03) than were reexperiencing and avoidance symptoms (P=.09 for both).

Conclusion: In this selected sample, daytime sleepiness was most strongly and independently associated with daytime dysfunction.

Published online: April 29, 2010 (doi:10.4088/PCC.07m00563gry).

Corresponding author: Joseph Westermeyer, MD, PhD, I Veterans Drive, #116A, Minneapolis, MN 55417 (

Prim Care Companion J Clin Psychiatry 2010;12(2):e1-e6